Drug Comparisons

Combined Alpha and Beta Blockers block alpha and beta receptors in the body to lower blood pressure. Beta blockers are medications that reduce the force and rate of the heartbeat. They also decrease tone in blood vessels. The alpha blocker component of these medications works to relax "peripheral" blood vessels (those in the arms and legs). This helps to lower blood pressure.

The name "beta blocker" refers to a medication that "sticks" to certain proteins located on various organs throughout the body. These proteins are called beta receptors. Beta blockers attach to the receptor and block substances that can raise blood pressure from attaching to it. The substances that can raise blood pressure are called catecholamines (pronounced: Kat-eh-KOL-uh-mEEns). Everyone has them, but they don't always cause hypertension. This may help explain why beta blockers work better in some people than others.

Combined Alpha and Beta Blocker medications relax blood vessels and help the heart beat more regularly. This helps reduce high blood pressure, also known as hypertension. Effectively treating hypertension has been shown to reduce illness and death associated with heart disease and to help prevent other diseases such as stroke and heart failure.

The seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends diuretics as initial drug choices for many patients, but Combined Alpha and Beta blockers may be a good choice for patients with heart failure, high cholesterol, or diabetes.

Drugs in this Class
Carvedilol Tablets (Coreg)
Carvedilol Extended-Release Capsules  (Carvedilol Extended-Release Capsules, Coreg CR)
Labetalol Tablets (Trandate Tablets)

Summarizing the Evidence

• Currently, comparative studies between the drugs in this class are lacking.

• Combined Alpha and Beta blockers are generally added on to first or second-line therapy for patients whose blood pressure is not controlled by other medications. Labetalol is sometimes used in cases of extremely high blood pressure. Labetalol may also be used for high blood pressure during pregnancy. The drug selected to lower blood pressure often depends on numerous factors including other diseases or conditions you may have, other medications you may be taking, and medication costs. Your doctor is the best person to decide what medicine is best to lower your blood pressure. li>

• Combined Alpha and Beta blockers are generally well tolerated with mild side effects. Common side effects of combined alpha and beta blockers include fatigue, dizziness, depression, low blood pressure and low pulse.

Dosing and Administration

• Carvedilol and labetalol are typically dosed twice a day. Carvedilol CR is typically taken as a once daily dose.

Generic Availability

• Labetalol and carvedilol have a generic equivalent available. Carvedilol CR (controlled release) does not have a generic equivalent

Drug Interactions

Some interactions between medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how the drugs interact and the severity of the interaction, please use our Drug Interactions Checker.

Side Effects

To view specific side effect information, please use our Side Effect Checker.

Additional Information

References

1. Coreg tablets [package insert]. Research Triangle Park, NC: GlaxoSmithKline; July 2007.
2. Coreg CR tables [package insert]. Research Triangle Park, NC: GlaxoSmithKline; July 2007.
3. Trandate tablets [package insert]. San Diego, CA: Prometheus Laboratories, Inc; December 2002.
4. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA. 2003;289:2560-2572.
5. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003; 26 (suppl 1):S80-S82.
6. Hunt SA, Baker DW, Chin MH, et.al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. Executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Available at: http://www.acc.org/clinical/guidelines/failure/hf_index.htm. Accessed: May 2, 2004 and June 2006.
7. Clinical Pharmacology Online. Available at: http://cpip.gsm.com/. Accessed July 10, 2007.
8. Weber MA, Sica DA, Tarka EA, et al. Controlled-Release Carvedilol in the Treatment of Essential Hypertension. American Journal of Cardiology 2006 Oct; 98(7A): 32L-38L.
9. Varon J. Treatment of acute severe hypertension: current and newer agents. Drugs 2008; 68(3):283-97.
10. Vigil-De Gracia P, Lasso M, Ruiz E, et al. Severe hypertension in pregnancy: hydralazine or labetalol. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2006 Sep-Oct; 128(1-2):157-62.

Last Updated: April 2008
This content was created by members of the DrugDigest team of experts and is solely under DrugDigest's editorial control.

Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It should not be construed to indicate that the use of the product is safe, appropriate, or effective for you. Consult your healthcare professional before taking any medication.